Audio & Quick Read Summary

1. Introduction

The Care Act 2014 came into effect on 1st April 2015. The Care and Support Statutory Guidance is the accompanying statutory guidance or local authorities and partner agencies.

The purpose of the Care Act is:

‘to make provision to reform the law relating to care and support for adults and the law relating to support for carers; to make provision about safeguarding adults from abuse or neglect; to make provision about care standards; to establish and make provision about Health Education England; to establish and make provision about the Health Research Authority; to make provision about integrating care and support with health services; and for connected purposes.’ (Care Act 2014)

It brought a number of different Acts into one single legislative framework of care and support for adults and their carers.

2. Clauses of the Care Act

Promoting wellbeing:
The wellbeing principle which applies to all functions under Part 1 of the Care Act (including care and support and safeguarding). Whenever a local authority makes a decision about an adult, they must promote their wellbeing.

Prevention:
The local authority is required to ensure preventative services are provided to help prevent or delay the development of care and support needs, or reduce such needs (including carer’s support needs).

Integration:
There is a duty on the local authority to carry out care and support functions with aim of integrating services with those provided by NHS or other health-related services.

Information and advice:
An information and advice service must be available to all people in the local authority area regardless of eligible care needs.

Market shaping:
There is a general duty for the local authority to promote diversity and quality in the market of local care and support providers. The local authority must ensure a range of providers is available; shaped by demands of individuals, families and carers; services are of high quality and meet needs and preferences of those wanting to access services.

Cooperation; general and specific:
There is a general duty for the local authority to cooperate with other relevant authorities which have functions relevant to care and support. This is supplemented by a specific duty where cooperation is needed for an adult with needs for care and support.

How to meet needs:
This relates to adults who need care and also carers; it provides examples of how needs could be met to ensure flexibility.

Assessment:
The local authority is required to carry out an assessment, known as a ‘needs assessment,’ where it appears an adult may have care and support needs. It also sets out what is to happen if an adult or a carer refuses to have a needs or carer’s assessment.

Carer’s assessment:
Creates a single duty to assess carers. It requires the local authority to carry out an assessment (‘carer’s assessment’) where it appears a carer may have needs for support now or in future.

Eligibility:
This requires local authorities to determine, following a needs assessment or carer’s assessment, whether a person has eligible needs. Regulations set out the eligibility criteria, including minimum level of eligibility at which the local authority must meet care and support needs.

Charging:
This gives the local authority a general power to charge for certain types of care and support, at its discretion.

Cap on Care Costs:
This allows for a limit to be established on the amount an adult is required to pay towards costs of meeting eligible needs over their lifetime. It also prevents the local authority from charging to meet needs (other than daily living costs) once the limit has been reached. Please note, this has not yet been implemented; the proposed new date is October 2025.

Financial assessment:
This requires the local authority to undertake a financial assessment if they choose to charge for particular service.

Duty to meet needs:
This sets out when local authorities must meet an adult’s eligible needs.

Power to meet needs:
This provides a broad power for the local authority to meet care and support needs in circumstances where a duty to meet needs does not arise.  It also allows for the local authority to temporarily bypass carrying out assessment of needs, where care and support is required urgently.

Duty to meet carers’ needs:
This establishes legal obligation to meet carer’s needs for support.

Exception for immigration:
This applies to adults subject to immigration control. It provides that the local authority may not meet care and support needs of such adults solely because they are ‘destitute’ or experiencing physical effects or anticipated physical effects of being destitute. If the adults needs have arisen for other reasons (for example a disability rather than solely destitution), the local authority is not prevented from meeting their needs.

Exception for provision of healthcare services:
In meeting an adult’s or carer’s needs, the local authority may not provide healthcare services which are NHS responsibilities.

Exception for housing:
This provides the local authority may not meet adult’s care and support needs by providing general housing, or anything else required under other legislation specified in regulations.

Care and support / support plan:
This details requirements for inclusion in care and support plans (for the adult) / support plan (for any carer).

Personal Budget:
This is the amount of money that the local authority has worked out it will cost to arrange the necessary care and support for that person. Local authorities must tell the adult what their personal budget is.

Review of Care and Support / Support Plan:
This requires the local authority to keep plans under review generally, and to carry out assessment where satisfied the person’s circumstances have changed. The adult can also make a reasonable request to have a review.

Independent Personal Budget:
Local authorities must prepare an independent personal budget for each person assessed by them as having eligible needs which the local authority is not going to meet. The independent personal budget must set out what the cost to the local authority would be if it was meeting the person’s eligible needs

Care account:
Local authority must keep an up-to-date record is kept of a person’s progress towards the cap on care costs.

Direct Payments:
People with mental capacity can request a Direct Payment and, where they meet conditions set out, the local authority must provide Direct Payments to meet their assessed eligible needs.

Deferred payments:
A ‘deferred payment agreement’  is an arrangement whereby the person agrees, with their local authority, to pay some of their care fees at a later date. The person usually repays the local authority from the sale of their property or it is repaid from their estate after they have died.

Continuity of care:
This sets out the duties the local authority is under when an adult, and potentially their carer, notifies the local authority of the intention to move to another local authority area. If the second local authority has not carried out assessment before the person moves, services must be provided based on care and support plan provided by the first local authority. The second  local authority must continue to provide this care until it has undertaken its own assessment.

Ordinary residence:
This helps the local authority identify a person’s Ordinary Residence for purposes of providing care and support. It also provides a mechanism for the local authority to reclaim money spent providing care and support to someone for whom they were not in fact responsible.

Adult safeguarding:
This sets out the local authority’s responsibility for adult safeguarding, including the responsibility to ensure enquiries into cases of abuse and neglect, establishing a Safeguarding Adults Boards, carrying out Safeguarding Adults Reviews and information sharing.

Human Rights:
This requires all care and support providers regulated by the Care Quality Commission are required to act in a way which is compatible with the European Convention on Human Rights.

Provider failure:
This sets out the duty on local authorities when providers fail. The local authority is required to temporarily meet the adult’s needs for care and support where they are no longer met as a result of provider failing.  It applies to all individuals present in the local authority area whose needs the local authority is not already meeting, that is self-funders and those whose services funded by another local authority.

Market oversight:
The Care Quality Commission has a duty to assess the financial sustainability of the most difficult to replace provider, and support the local authority to ensure continuity of care when providers fail.

Transition from childhood:
The local authority has a duty to assess a child, young carer or child’s carer before they turn 18, if they are likely to have needs once they (or the child they care for) turn 18, in order to help them plan and if this assessment will be of ‘significant benefit’.

Advocacy:
Places a duty on the local authority in specified circumstances to arrange an independent advocate to facilitate involvement of an adult or carer who is subject of assessment, care or support planning or review.

Recovery of charges, transfer of assets:
This allows the local authority to recover as debt any sums owed, such as unpaid charges and interest.

Delayed discharges:
This sets out the process for notification of discharge when an adult has care needs, and a requirement for assessment.

Mental health aftercare:
This clarifies aftercare services provided under section 117 of the Mental Health Act 1983 to meet need arising from / related to mental disorder of person concerned.  It aims to reduce the likelihood of deterioration in a person’s mental disorder (and therefore reduce risk of hospital admission for treatment).

Prisoners:
This sets out responsibilities for provision of care and support for adult prisoners and people residing in approved premises (including bail accommodation). Such adults should have needs assessed by the local authority, and where they meet eligibility criteria, services are provided by the local authority.  Prisoners’ non-eligible needs will be met by the prison service.

Registers:
This requires the local authority to continue to establish and maintain register of sight impaired people. It also enables the local authority to establish and maintain a similar register of those who need care and support or are likely to do so in future.

Delegation:
This provides a power for local authorities to authorise a third party to carry out certain care and support functions.

Cross border placements:
This makes provision for a person with care and support needs who is ordinarily resident in England, and who requires residential accommodation to meet those needs, to be provided with accommodation in another part of UK. It also allows for such placements in England for people ordinarily resident in Wales, or whose care and support is provided under relevant Scottish or Northern Irish legislation. Also there are similar arrangements for cross border placements not involving England i.e. Wales / Scotland, Scotland / Northern Ireland and Northern Ireland / Wales.

3. Further Reading

3.1 Relevant information

An Introduction to the Care Act 2014 (SCIE Video)

Care Act – Legal Duties; Bite Size Videos (SCIE)

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